Changes in executive function in pediatric brain tumor survivors

Abstract

Objective: Pediatric oncology survivors are at risk for executive function (EF) and working memory (WM) deficits, which can be measured via performance-based measures or rating scales. Previous studies have shown these measurement methods to be weakly correlated. This study aimed to describe parent-rated EF and performancebased WM (PBWM) in pediatric brain tumor (BT) survivors, examine change in EF and PBWM across time, and investigate the relationship between parent-rated WM and PBWM. Method: The sample included 56 patients diagnosed with a BT in childhood (M age = 6.94 years; SD = 4.05) seen twice for clinical neuropsychological evaluation. PBWM was examined via the auditory WM scale from a Wechsler intelligence measure or Differential Ability Scales-II. Parents completed the Behavior Rating Inventory of Executive Function (BRIEF)/BRIEF-P/BRIEF-2 as a measure of global EF (Global Executive Composite [GEC]), metacognitive skills (Metacognitive Index/Cognitive Regulation Index [MI/CRI]), behavioral regulation (Behavior Regulation Index [BRI]), and emotional regulation (Emotion Regulation Index [ERI]).Results: GEC, MI/CRI, and ERI at Time 1 were significantly above the mean (p < .01); BRI and PBWM did not differ from the normative mean. All measures were significantly higher than the normative mean at Time 2 (p < .05). PBWM was both clinically and statistically elevated (p < .001). There was a significant change across time in PBWM (p < .05), but not GEC, MI/CRI, ERI, or BRI. PBWM was weakly correlated with the BRIEF WM subscale at Time 1 and Time 2 (all p > .05). Conclusions:Multiple measures of EF should be considered when providing diagnoses and recommendations for pediatric BT survivors. Furthermore, given declines across time, findings document need for continued monitoring and reassessment of survivors as they get further out from treatment.

Amyloids and brain cancer: molecular linkages and crossovers

“…In another study, poor working memory has been observed among pediatric brain tumor patients, linking memory loss with primary brain tumor irrespective of the patient’s age [ 57 , 58 ]. Pediatric primary brain tumor survivors also show long-term working memory impairment after radiation and other therapeutic measures [ 59 , 60 ]. Among adult patients, neuropsychological evaluations reported major episodic memory loss with a primary brain tumor and continued even after resection of the tumor [ 61 , 62 ].…”